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Pulse Magazine Winter 02 Issue

In this issue...

A Constructive Beginning(Cover Story)

School of Medicine Names New Dean

Living with AIDS

Wellness Center

Radical Difference

Response to Pharmacy, Pediatrics Shortage

Rounds - News, Views and Trends

The Last Word: A Medical School for West Texas

A CONSTRUCTIVE BEGINNING: Campus Master Plan Means More Than New Buildings
By Mary Hudspeth

Since its inception in 1996, the Campus Master Plan for Planned Growth has become a physical symbol of Texas Tech University and the Texas Tech Health Sciences Center's tremendous growth. There has been close to a $150 million investment in the Texas Tech Health Sciences Center over the last several years and about $120 million under construction or in planning today.

The Campus Master Plan simultaneously creates a vision of the campus of the future and provides a blueprint for the development of new buildings, new open spaces and new infrastructure, according to Mike Ellicott, vice chancellor for facilities planning and construction. 'The Campus Master Plan addresses both the challenge and the opportunities facing the health sciences center as it renews and enhances its physical environment on all its campuses. The plan's goal is to create a campus with great spaces to live, work and play," he said.

The Campus Master Plan is a blueprint for new construction, new infrastructure, traffic and parking modifications, necessary demolition and enhancement of the pedestrian space on the all the Texas Tech campuses.

David R. Smith, M.D., president of the Texas Tech Health Sciences Center and interim chancellor of the Texas Tech University System, says that while Texas Tech is making great strides on the Master Plan, the key really isn't about the dollar figure or about the construction itself, but is really about the students, faculty and staff.

"The key is what is needed to support our vision and our aspirations. We have witnessed a burgeoning of the reputation of the Health Sciences Center across the southwest and nationally. Our new academic initiatives are impressive as are our new degree offerings, Texas Tech's leadership in aging, women's health, rural health and diabetes is unparalleled ," he said.

The face of the Health Sciences Center building will soon see some dramatic changes. Construction of a new academic classroom building in front of the west end of the existing building will start in February. The project will include more than 20 classrooms, seminar and meeting rooms and will feature Internet and HealthNet technology. Texas Tech facilities experts and Health Sciences Center faculty and staff are in the process of selecting a designer for a new clinical tower/research center on the Lubbock campus. Construction will be in front of the east end of the building, Ellicott said.

Another upcoming project on the Lubbock campus is construction of a new student center, the F. Marie Hall Synergistic Center. The center will be adjacent to the classroom building and will include a workout room, showers, a television lounge area complete with Internet capabilities, offices for student senate executive officers and an outside patio area with pool tables, foosball and table tennis. It will be an epicenter for student-centered activities. The center will also contain offices for student services including the registrar, financial aid offices and offices for student organizations.

On the Amarillo campus, a new academic building for the Schools of Medicine and Allied Health is under construction and should be completed by March 2002. A project to expand the academic clinic building in El Paso that will house the departments of pediatrics, emergency medicine, ophthalmology, graduate medical education and research offices is currently being designed and planning for a new $40 million research facility is now underway. In Odessa, a new academic and clinical building recently was completed and a joint project with Midland College to house the physician assistant program opened Aug. 15.

The work being done by the health sciences center in the areas of rural health, diabetes, border health, pain management and cancer has gained attention for Texas Tech not only on the South Plains, but statewide as well as nationally. As a result, the health sciences center is seeing an increase in the undergraduate and graduate programs offered here as well as enrollment.

The work being done by the health sciences center in the areas of rural health, diabetes, border health, pain management and cancer has gained attention for Texas Tech not only on the South Plains, but statewide as well as nationally. As a result, the health sciences center is seeing an increase in the undergraduate and graduate programs offered here as well as enrollment.

"Our goal was not to stand still on enrollment. We believe that the best measure of the value of this health sciences center is reflected by the number of students who attend here," Smith said. "We believe they are getting a quality education."

Smith added that nationwide, many of the health sciences centers are seeing a stagnation or even a drop in enrollment, particularly in the areas such as nursing, allied health. There has even been a decline until very recently in the number of applicants to medical schools. "

This health sciences center, unlike almost all of our colleagues in Texas, and most of our colleagues nationally, has seen an increased interest in both represented by more applicants and increased enrollment," Smith said. Additionally, the other mission of Texas Tech Health Sciences Center, research, has seen a three-fold increase in research dollars garnered from federal state and private sources over the same five-year period.

"Our faculty has grown, the number of degrees have markedly increased, particularly in the schools of Allied Health and in our graduate school, the Graduate School of Biomedical Sciences, where enrollment is up almost 200 percent in the last five years," he said.

On all campuses, the investment has been very specifically targeted to enrich each of them individually. In some cases, providing each campus with unique characteristics can define it nationally. "An example of each campus's individuality is what we're doing in El Paso with the border initiatives and some of the modifications and discussions in Amarillo around women's health issues, so that each one can have a niche that provides an opportunity for uniqueness and for academic and research recognition," Smith said. As a result, there has been almost a 15 percent increase in enrollment at the health sciences center over the last three years.

"We are rapidly heading to the 2000 figure that I suggested would take us five years to achieve. The goal that was outlined just a little over a year ago in the state of the university speech appears to be attainable as soon as next fall if not before," he said.

In 1991, the Texas Tech Health Sciences Center had less 1,000 students, and now, just a little over ten years later, the student body has nearly doubled. "Even in the fall of 1995, we had 1,326 students and here we are in the fall of 2001 with just slightly less than 1,800 students. What I'm particularly proud of though, is not just the numbers, it's also the quality of our students, and not only their pre-university credentials, but also their performance here," Smith said.

One such example is the recent announcement that 100 percent of the School of Pharmacy students for the second straight year, passed their national board exams. The most recent group of students in the School of Nursing also had a 100 percent passage rate on their exams.

"This isn't just about trying to increase numbers for sake of growth, it's the fact that we have unprecedented quality in our students, which in the case of our health professionals is often measured by an external source, such as with a license," Smith said. "Again, I am very proud of the superb performance by our graduating medical students, pharmacy students, nursing and allied health professionals."

Smith believes that the Texas Tech Health Sciences Center has an unbelievable product in the health sciences that is interdisciplinary. It provides everything from the doctoral level programs to the doctors of audiology, doctors of pharmacy, medical doctors, graduate programs including doctorate programs in nursing. He also credits the health sciences center faculty with the center's success.

The Master Plan supports the goals of educating the finest health professionals in the finest facilities. "Instead of focusing on the numbers and the facilities, one needs to focus on what goes on in them. Texas Tech is growing, and our graduates are assuming leadership positions throughout the sate and country, and in order for Texas Tech to keep up with the role that Texas Tech has now assumed, we need to be able to keep up with our facilities," he said.

The other part of the master plan is critical, because it's not just about the bricks and mortar infrastructure, it also includes information technology, which may become the most critical piece of infrastructure that is out there in the future.

When one looks at the master plan, it is important to look at what's going through the walls and above the ceilings, not just the four walls and the screen and the seats, one has to envision the wiring or eventually being able to go wireless to be able to provide access to education.

"This really is a master plan of education, not a master plan of facilities. The exciting thing is that we are well on our way to realizing a large percentage of that master plan that we laid out just 3 and a half short years ago. A great deal of credit goes to the legislature for that," Smith said. "So the Master Plan is really not about a master plan, it is about meeting the needs of a growing and vibrant university."

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Richard Van Ness Homan, M.D., chair of the Department of Family and Community Medicine at Texas Tech University Health Sciences Center, has been named the new dean for the Texas Tech School of Medicine and the Graduate School of Biomedical Sciences.

David R. Smith, M.D., interim chancellor for the Texas Tech University System and president of TTUHSC, says Homan's vision and strong background will keep the momentum going strong for the School of Medicine.

"Dr. Homan is an outstanding physician and administrator," said Smith. "He has proven experience in a medical school system and his reputation among his peers is excellent."

Ronald Rapini, M.D., chairman of the Department of Dermatology, served as the chairman of the committee that advised Smith and says Homan has made the Family and Community Medicine department a successful and a highly ranked program.

"This committee looked at Dr. Homan's clinical expertise and administrative endeavors which are legendary at TTUHSC," said Rapini. "He has been instrumental in bringing a great amount of grant money to the institution, and we feel he will take us into the next era with his leadership."

Homan says he looks forward to the challenge as School of Medicine and Graduate School of Biomedical Sciences dean. "Many initiatives have been started which we will continue to build upon, and there are many other projects that need to be started," said Homan. "I am excited to serve the university in this capacity, and along with my colleagues on each of the four campuses, we will continue the excellence in medical education, clinical service and research for which this school is known."

Some of Homan's professional experience include serving as the associate dean for Clinical Practice at TTUHSC, chief of staff at University Medical Center, medical and executive director of Student Health Services, medical director of the Institute of Healthy Aging, co-fellowship director of the Sports Medicine Fellowship at TTUHSC, co-medical director for the Primary Care Center at UMC, and residency director for the Department of Family and Community Medicine

Homan earned his bachelor's degree from Brown University in Providence, R.I. in 1978 and his medical degree from the State University of New York at Buffalo School of Medicine in 1982. He completed his residency and served as chief resident at the Milton S. Hershey Medical Center of Pennsylvania State University. He also served as clinical assistant professor at Pennsylvania State University School of Medicine before coming to TTUHSC in 1989.

Homan and his wife, Rita, have three children, Andrew, Katherine and Gregory.

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LIVING WITH AIDS: 20 Years of Research Leaves Scientists Still Looking for Vaccine
by Andrea Watson

For almost 20 years the stigma of HIV and AIDS has been a fixture in our country and across the world. And for nearly as long, researchers have been looking for a cure for those infected and for a vaccine to keep others from acquiring the disease. It has, however, been a long and often fruitless search.

Ronald C. Kennedy, Ph.D., chairman of the Department of Microbiology and Immunology at Texas Tech University Health Sciences Center, has been involved with the search for a vaccine almost from the beginning.

"I first heard about this rare form of cancer that caused an immunodeficiency in 1982 while I was working at Baylor College of Medicine," Kennedy said. "The cause was unknown but it was felt that it was probably virus-based.

"The lab I was working at had a lot of experience from the standpoint of designing synthetic molecules, so in 1983, when the putative agent of HIV was isolated - at that time it was called HTLV-3B - my mentor had me hop on a plane to Washington D.C. I took a cab to Bethesda, Md., went into Building 10, which is the National Cancer Institute, walked into the lab of Dr. Bob Gallo, one of the discoverers of the virus, picked up a flask with some culture tissue medium and this virus, stuck it in my jacket pocket and flew back to Baylor to start working on it."

Kennedy and his fellow researchers then began working to identify key components of the virus that could be replicated synthetically. The results of subsequent studies of these synthetically produced components brought the national spotlight to Kennedy, who was then in San Antonio, and his colleagues.

"In 1986, CBS News came in and did a big story," he said. "We had had initial success, so I said I thought we'd have a viable vaccine in three to five years. I was way off on that one. What we actually learned was that what we had isolated was an important piece, but it wasn't the whole scenario."

Over time, Kennedy, his colleagues and researchers across the country continued to try new and different approaches to find both a vaccine and a cure.

"We dealt with a lot of approaches and essentially came up with the scenario that this was going to be a very difficult thing to produce," he said. "But what has happened over time is that politics has lowered the standard and criteria for what is considered a successful vaccination. A lot of it is based on ethnology from a standpoint that if you look at underdeveloped countries where you may have one-third of the population infected, a 100 percent success rate is an overly high goal. If we can do something with around a 30 percent success rate, then we're saving a whole generation of the country."

Kennedy admits that researchers still don't really know what types of immune system responses will truly be effective against HIV.

"Some people say that antibodies are important, some people say that immediate response is important and some say both responses are important," he said. "There is evidence from both camps, but I tend to think antibodies are more important. But the bar is set such that if you get some kind of response, it's good enough.

"I take a different look at it. I don't think that 30 percent is good enough. When I hear the word vaccine, I think that if you are vaccinated, you are protected."

One of the key problems in developing both a vaccine and a cure is that there are so many subtypes of HIV, Kennedy said.

"There are 13 subtypes and part of the problem is that if you develop a vaccine against subtype B, it's not necessarily going to work against subtype C or subtype E. In fact, chances are it's not. So the big thing is trying to target something that sees all these subclasses of the virus. We also don't know how effective the drugs used to treat HIV are against these different subtypes. In theory, they should be effective, but in reality, theory and HIV never work."

Another problem, Kennedy said, is that, normally, technology eventually becomes smarter than the infectious agent but that's not true in the case of HIV.

"We have better tools to work with and a better understanding, but we can't figure out how to get a human immune system response," he said. "It's just not that easy."

Of course progress has been made in treating HIV infection with medication, he said. However, these new treatments have also led to a distressing trend.

"We're seeing an upswing in the number of cases in the West," he said. "One reason is because we have these new drugs that are now very effective at reducing viral load. We also have this belief that a vaccine is very close. So we're getting a lot of the high-risk behaviors that were modified during the early to mid 1990s in high-risk populations coming back into vogue. We're also seeing the scenario where we're starting to see new subtypes becoming more predominant because of these high-risk behaviors."

Kennedy said the research is making progress, but people should not count on a vaccine being developed anytime soon.

"I haven't made a prediction in a while," he said. "It's just too hard to say when it will happen. You've got a lot of people working on something they want to find very badly. As basic researchers, we understand the type of response that should be required to make a vaccine. The problem is, when we try, we never quite get there. The reality of it is, it's a difficult task."

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by Kaley Paris

"I thought my daughter was having a stroke," said Dale Casta�eda, an assistant schoolteacher at Harwell Elementary and loyal patient of the Texas Tech University Health Sciences Center School of Nursing's Wellness Center. "Half her face was numb and her speech was slurred.

"I called the Wellness Center and they said to bring her in right away," she said. "The nurses at the center did everything they could to help me understand what was wrong with my daughter and ease my worries."

Casta�eda's daughter had Bell's palsy. Bell's palsy, a paralysis or weakness on one side of the face, can come on suddenly or may appear over several days.

Casta�eda says the center's nurse practitioners managed her daughter's condition and helped her understand what was going on with each visit. Teaching about health care problems and concerns is a vital component of the nurse practitioner's role.

Ruan Reast, R.N., F.N.P., a nurse practitioner at the Wellness Center, believes the best thing about the center is the fact that it is nurse-managed.

"Nurses are educated to look at more than just the physical problems with a patient," Reast said. "There's a lot of emphasis in the School Of Nursing's education program on taking a holistic approach, or exploring beyond the physical problems and into the variety of possible social problems.

"I think this approach would benefit anybody, no mater where you live, no matter what your economic status," Reast said. "And this approach works well for this under-served community, not only because they are underserved medically, but also educationally in regards to the resources that are available to them."

Casta�eda, a mother of four, began utilizing the center when it opened in the fall of 1999 and has taken her children there ever since. Casta�eda says the center's friendly environment feels more like a family. The fact that they recognize her voice over the phone and her face when she visits always makes her feel better, she says.

"The people at the center are professional, but they don't treat you like they're better than you," Casta�eda said. "They explain everything to you, they make check up calls after your visits, and they're always smiling. Plus the price helps me out tremendously, as a single parent, and I know that I can afford health care for my kids there." Casta�eda was able to obtain health insurance for her children through information provided by center staff.

Casta�eda said she only considered going to a doctor's office for emergencies before the center opened. She explained that at other doctor's clinics, it would've taken her a long time to get in and then she would've had to miss an entire workday for the visit.

"Now, I just call the center, tell them what's wrong and they get me in as soon as possible," she said. "They always work with my schedule and get me in either that day or the next. The fact that they usually get you in and out pretty quickly helps a lot, too."

The Wellness Center, owned and operated by TTUHSC's School of Nursing, is located on the east-side of Lubbock at 3703 Ave. A. The center recently received a five-year grant totaling $1.7 million from the U.S. Department of Health and Human Services.

Christina Esperat, Ph.D., FNP, professor and associate dean for research and practice in the School of Nursing, says this funding will allow the center to expand its chronic disease management programs for diabetes, hypertension, obesity and asthma.

"The grant will allow the center to hire a full-time family nurse practitioner who can implement these programs," Esperat said. "This will actually involve providing therapeutic management to patients with these diseases, as well as assisting them to manage and control their own chronic conditions at home."

Cindy Acton, R.N., M.S.N, operations director for the center and clinical instructor for the School of Nursing, says they are anxious to get the ball rolling.

"We opened kind of quietly in 1999, but we're now ready to roar," Acton said. "We had such a fragile financial status in the beginning, but now that we're gaining financial support, we're really ready to get out in the community and make an impact."

Acton says, because of the grant, the center will not only be expanding their physical space, but will also be developing four key programs for hypertension, diabetes, obesity and asthma.

"These programs were chosen because they were among the most common problems found within our population, and they also fit in with the grant's, and nation's, goals for 2000," Acton said. "When we applied for the grant, we used these issues to our advantage by pointing out that if we were to receive the money, not only would we be aiding the patients in this area, but we would also be aiding the goals of the nation."

Reast says the grant also will provide opportunities to hire people for new positions at the center. They are currently developing job descriptions for a dietitian, a patient educator who will cater to different patients' learning styles, case-managers that will assist patients with their finances, and an outreach person who will be dedicated to and work more closely with the Medicaid population.

"We'll hope to implement classes for our patients," Reast said. "For instance, a walking class for diabetics and exercise classes for all patients."

Reast says the most gratifying part of being a nurse practitioner is knowing that by the end of the day she's made a difference.

"Every once in a while, someone will tell me 'thank you so much for helping me,'" Reast said, "and my job allows me to see people get well or at least become comfortable with their situation."

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RADICAL DIFFERENCE: New Surgical Technique Reduces Recovery Time & Scarring

Not so long ago, the thought of having major surgery without a large incision was only a dream. But today, through the work of two Texas Tech University Health Sciences Center surgeons, operations that would have once left a major scar can now be performed with only a few small incisions.

"My vision is that anything that can be done with an open incision should be done laparoscopically," said John P. Thomas, M.D., an assistant professor in the Department of Surgery at Texas Tech University Health Sciences Center. "Minimally invasive surgery is radically different for the patient. It's harder for the surgeon, but the outcome is so much better for the patient that it's worth it."

Thomas and Ari O. Halldorsson, M.D., chief of cardiothoracic surgery and an associate professor in the Department of Surgery, have brought this relatively new technique - called minimally invasive surgery - to the Health Sciences Center. The two previously worked at Louisiana State University.

Minimally invasive surgery involves making several small incisions in the abdomen or chest depending on the procedure. All of the necessary surgical equipment including telescopic cameras and special surgical instruments are then inserted through these incisions.

"The whole procedure is quite different," Thomas said. "No. 1, you have to do all your dissections with the laparoscope and use chopsticks basically to pull and tug on things. Usually, you use your hands to feel and pull things. This technique forces you to become more aware of the sensitivity of touch. You have to use an inanimate object to replicate your sense of touch."

Having to use inanimate objects to replicate the sense of touch is one of the reasons minimally invasive procedures are harder on the surgeon, Halldorsson said. It is also why minimally invasive procedures often take longer. That's why the doctors hope to open a lab where surgical residents and other surgeons can practice manipulating the laparoscopic instruments by playing checkers or doing other tasks with only the view from the camera.

Minimally invasive procedures have numerous benefits for the patients, the doctors said, making it the method of choice for more and more surgical procedures.

"This allows more people to become surgical candidates than before," Halldorsson said. "We can now do procedures on people such as smokers with emphysema or other severe lung diseases and they're much more likely to come through OK and with less complications. With open surgery, these people would be considered extremely high-risk or wouldn't be surgical candidates at all."

Some types of surgery also become more feasible using the minimally invasive technique, Thomas said.

"This is a great way to help people with acid reflux," he said. "Rather than taking a pill every day or drinking a lot of milk, we can operate on them and they don't have to depend on those things."

Halldorsson said the technique is currently being used for a variety of cardiothoracic procedures including lung biopsies, partial or complete lung removal and even some heart procedures, although most heart surgery must still be done with the open technique.

Part of the reason more patients can have these types of procedures is the shorter recovery time. Patients who undergo minimally invasive surgery are usually out of bed and have minimal pain within days, Thomas said. With open surgery, patients can be confined to bed for a long period of time and typically have a great deal of pain.

"The reason this is so important is the patient's ability to go back to a normal life," he said. "Rather than being down for three or four weeks, they're down for three or four days.

"I recently did a spleen operation on a 74-year-old woman and she went home on day two following the operation. She was so happy she had done it this way. If we had done it the other way, she would have had a large incision and been in the hospital for quite a few days."

Patients also like the benefit of having less scarring. Both surgeons say this shouldn't be a factor in determining whether to have surgery, or how it's done.

"The cosmetic benefits are only secondary," Halldorsson said. "The main benefit of using smaller incisions is a shorter and easier recovery."

While many patients prefer to have a minimally invasive procedure once they learn of the technique, the surgeons have to remind them that the possibility still exists for an open procedure to be necessary.

"Most people are not aware of this," Halldorsson said. "I always tell the patient that we can try the operation thoracoscopically, but that we may have to open them up. Sometimes we just can't perform the procedure that way or we need to work faster than it allows. The patient always has to be aware that we might have to resort to the old way."

Despite the newness of the technique, Thomas said patients are very receptive to the option of a minimally invasive surgery and to the possibility of still having to undergo an open procedure because they understand his motivation.

"They don't feel like guinea pigs because they don't feel like this is an experiment," he said. "They know this technology has been around for a while. Patients are willing to have this done if it can be. But, the most important thing is to get the disease out of the patient, not whether we can do the procedure laparoscopically. It's not important to prove that I can do this laparoscopically if it's going to hurt the patient. If the minimally invasive procedure isn't going to happen, fine, I'm not going to cheat a patient out of a good operation or cheat the patient out of survival. I will do whatever is best for my patient."

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Texas Tech University Health Sciences Center's School of Pharmacy has initiated several community partnerships in its mission to produce doctors of pharmacy for the Dallas/Fort Worth Metroplex, said Arthur Nelson, R.Ph., Ph.D, dean of the school.

Following an agreement signed this summer, Nelson said the top six students from the University of Texas at Arlington's pre-pharmacy program now have a guaranteed place at Texas Tech School of Pharmacy.

The aging of America has created a nationwide shortage of pharmacists, Nelson said, but the problem is worse in the Dallas/Fort Worth area because the region had no school of pharmacy before Texas Tech established its Metroplex campus in 1999.

Nelson said studies show that healthcare professionals tend to set up their first practice in the city where they completed their highest level of training.

Therefore, after completing classroom work, the participating students will complete their clinical training and required internship at the School of Pharmacy's Metroplex Campus.

To earn a doctor of pharmacy degree, a student must study at a four-year pharmacy program and complete at least a two-year pre-professional curriculum. Because only four pharmacy schools in Texas offer such a program, Nelson said waiting lists are often long. For the 2001 class, Texas Tech accepted 72 pharmacy students but was forced to turn away 106 students who were fully qualified.

Nelson said being able to identify young people early in their careers who are talented and motivated will be very beneficial.

This is the first time Texas Tech in Amarillo has entered this type of agreement. Students who wish to participate must receive approval from the College of Science at University of Texas at Arlington, complete two years of pre-pharmacy and core curricula, maintain a 3.2 grade-point average and be active in extracurricular activities.

Nelson said the school of pharmacy also has an agreement with Children's Medical Center of Dallas to produce doctors of pharmacy who are specialized in pediatrics and plan to remain in Dallas.

"We strongly support our commitment to pediatric education," said Nelson. "We are extremely pleased to develop this relationship with one of the premier children's institutions in the country,"

Nelson said Children's Medical Center's commitment is the largest scholarship offered at the School of Pharmacy. Children's Medical Center of Dallas has agreed to fund $5,000 scholarships that two students from each Pharm D. class will receive annually for the duration of their 4-year studies. Children's Medical Center also will supply a laptop computer required by the school for its computer-based curriculum. In return, students accepted into this joint program will complete their third and fourth school years at Texas Tech School of Pharmacy's Dallas/Fort Worth Regional Campus.

"This speaks to our joint commitment to provide the best care for the children of the Metroplex," Nelson said.

Nelson said most schools of pharmacy don't have significant required coursework in pediatrics. Even if pediatrics is included in the curriculum, students rarely get exposed to pediatrics before the last year of pharmacy school. Often they have already made career decisions by this time.

He said few postgraduate education programs in pediatrics exist and even fewer turn out graduates on an annual basis (general practice residency, pediatric specialty residency, pediatrics research fellowship). These factors contribute to a very unpredictable year to year marketplace for children's hospitals seeking pediatric pharmacists.

Texas Tech School of Pharmacy has a commitment to educating and training students in pediatrics. Students are required to do a pediatric clerkship during the P4 school year and students do receive instruction in pediatric pharmacotherapy during their coursework.

With seven specialty-trained pediatrics faculty, the School of Pharmacy has the largest number of full-time pediatric faculty members of any school of pharmacy in the United States. The school already has developed pediatric specialty residency programs on the Amarillo and Lubbock regional campuses, Nelson said.

The School of Pharmacy's Dallas campus was established by the Texas Higher Education Coordinating Board in 1999. Students spend the first 2 years in Amarillo and the third and fourth years and postgraduate work in the Metroplex. Ninety third-year, fourth-year and postgraduate students study in Dallas.

Children's Medical Center of Dallas is well-known and respected for high quality patient care, education and research. Nelson said Children's Department of Pharmacy is progressive and is using a state-of-the-art combination of technology and decentralized pharmacy services to improve patient safety and pharmacotherapy outcomes.

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Rounds: News, Views & Trends


Texas Tech University System Board of Regents today announced that David R. Smith, M.D., would serve as interim chancellor of the system beginning Sept. 3. Smith will continue in his capacity as president of the Texas Tech University Health Sciences Center. Smith has served in that position for almost five years.

"In filling the interim position, we sought an individual who could continue Chancellor Montford's high-profile fund-raising effort. We also wanted an individual who could work well with alumni, faculty and students. There were any number of individuals on this campus who would have been excellent interim administrators. The regents believed that at this time, Dr. Smith was the best individual to step in,'' said Robert Brown of El Paso, chairman of the board of regents.

Smith will serve for an indefinite period of time as regents work to select a replacement for Chancellor John T. Montford. Montford announced his intention to step down last week.

Brown said that he anticipates that regents will discuss the process for selecting a new chancellor at its Aug. 10 meeting.

"It's an honor to continue the work of Chancellor Montford. He has done a tremendous job raising the visibility of Texas Tech, increasing its fund-raising potential and building research infrastructure,'' said Smith

"I look forward to continuing my close working relationship with David J. Schmidly, president of Texas Tech University. It is my goal to maintain the system's progress and momentum. Texas Tech is a system where the interests of students come first and a system that recognizes its best investment is in its faculty. I will work very hard to ensure that we continue to make that investment,'' Smith said. "I'm personally proud of both of these universities,'' said Smith.

Montford praised the board's decision to select Smith. "David is an excellent choice. He will affect an orderly transition. He also will commit his full energies to furthering the goals of the regents and the system,'' Montford said.

Prior to his tenure at Texas Tech, Dr. Smith served as Commissioner of the Texas Department of Health from 1992 to 1996, overseeing Medicaid within this $6.5 billion agency. From 1989 to 1992, Dr. Smith was senior vice president of Parkland Memorial Hospital in Dallas and chief executive officer and medical director of Parkland's community Oriented Primary Care Program.

He also has previously served as deputy director of the U.S. Department of Health and Human Services Division of Special Populations and Program Development in Washington, D.C.; and medical director of the Brownsville Community Health Center in Texas' Lower Rio Grande Valley.

Smith earned his undergraduate degree from Cornell University and his medical degree from the University of Cincinnati. He completed his pediatrics residency at Children's Hospital of Philadelphia.

Smith is married to Donna Bacchi, M.D.; and they have two children.


The Physician Assistant (PA) Program within the School of Allied Health at Texas Tech University Health Sciences Center - Permian Basin is no longer operating out of portable trailers. After three years of planning and construction, the 35,000-square-foot state-of- the-art Dorothy and Todd Aaron Medical Science Building has become a reality. The building houses the TTUHSC Physician Assistant program and Midland College's health-related programs. Each program is located in separate buildings that are joined by a courtyard.

The 17,500-square-foot Physician Assistant building is equipped to provide the full teaching experience to PA students with the exception of clinical internships. The interactive conference room is equipped with HealthNet equipment that allows for meetings to be held with other campuses. The teaching auditorium is also equipped with HealthNet as well as individual Internet ports for each student. Other unique features of the building include a library, computer lab, interviewing lab, a student lounge and clinical examination room. The d�cor is heavily entrenched with TTUHSC colors and insignia.

"We are extremely fortunate to have such a spectacular facility for our Physician Assistant program. The new facility will accommodate all of the instructional and support needs of the students as well as the faculty and staff," said Robin Satterwhite, regional dean of the School of Allied Health.

"The new facility greatly enhances our learning opportunities as it enables us to have better access to much needed resources," said Sarah Shanks, physician assistant student that will graduate in December of this year.

The PA program fulfills the mission of TTUHSC by responding to the need for primary health care providers in rural or underserved regions of Texas. There are currently 129 PA training programs in the United States, seven of which are in Texas. The TTUHSC Program is the only PA training facility serving the 108 counties of West Texas. The Dorothy and Todd Aaron Medical Science Building enables TTUHSC to lay claim as the only health sciences center in the country with a stand-alone structure dedicated exclusively to the education of physician assistants.

The TTUHSC PA program is an intensive 31-month medical education curriculum focused on primary care. Students undergo 15 months of classroom and laboratory training in basic medical sciences, applied behavioral sciences and clinical didactic instruction. This is followed by a year of eight clinical clerkship experiences in family medicine, internal medicine, pediatrics, geriatrics, psychiatry, surgery, perinatal care/gynecology and emergency medicine. The cooperating clerkship sites are located in clinics, hospitals and managed care facilities throughout West Texas. The terminal semester of the curriculum is dedicated to graduate preparation, including the composition of a professional-level manuscript.

The graduate PA is then academically and clinically prepared to provide health care services under the supervision of a licensed physician. Direct supervision is not required and many PA's practice autonomously in rural areas.

The first class of 16 TTUHSC physician assistant students began their studies in June 1999. They will complete their studies with a master of physician assistant studies in December 2001. The second class of 12 students began in June 2000 and will finish in December 2002. A third class of 20 students just completed the first semester of studies and will complete the program in December 2003.

The Mildred and Shirley L. Garrison Geriatric Education and Care Center
A Tradition of Caring

The Garrison Center brings to life a dream shared by Sears Methodist Retirement System, Inc. and Texas Tech University Health Sciences Center. One of the predominant philosophies of The Garrison Center is to focus upon the abilities - rather than the inabilities - of residents.

The Garrison Center is a member of the Sears Methodist Retirement System and continues their tradition. For over 35 years, Sears Methodist has been a provider of geriatric nursing care and age-related dementia care. Because of the partnership between Sears Methodist Retirement System and Texas Tech University Health Sciences Center, The Garrison Center residents and their families will have the added benefit of opportunities to participate in education and research activities.

The Mildred and Shirley L. Garrison Geriatric Education and Care Center is anticipating opening early 2002. A potential resident waiting list is being developed.


Alexia Green, RN, Ph.D., dean of the Texas Tech University Health Sciences Center's School of Nursing, recently was selected as a Robert Wood Johnson Executive Nurse Fellow. Only 20 nurses nationwide were selected this year to participate in the three-year program.

The award includes a $30,000 grant for a leadership project at the health sciences center, as well as opportunities for educational and national exposure. Green's leadership project will focus on assisting in the future direction and mission of the health sciences center's Institute for Healthy Aging. It is the goal of the Texas Tech Health Sciences Center to make the institute a source of cutting-edge education, research and care for older persons across the state and nation.

"Dr. Green has been a tremendous asset to the Health Sciences Center in the relatively short time she has been dean," said David R. Smith, M.D., interim chancellor and president of the Texas Tech Health Sciences center. "She is ready and willing to help lead and shape the U.S. health care system of the future."

Green became dean of the School of Nursing in June 2000. She also served as president of the Texas Nurses Association until July 1, providing significant leadership in addressing public policy issues related to solving the nursing shortage and other workplace issues.

The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care.


Donald M. Loveman, M.D., F.A.C.P., has been appointed as the new regional dean of the School of Medicine at Texas Tech University Health Sciences Center in Odessa.

Dr. Loveman, an associate professor of medicine, previously served as regional chairman of the Department of Internal Medicine and assistant regional dean for education and research at TTUHSC- Odessa.

"As the new regional dean for the School of Medicine, I have two major goals. The first is to provide the highest standard of healthcare for individuals in the Permian Basin who select to see School of Medicine faculty in Odessa and Midland. Secondly, I would like to substantially increase and develop the research and educational bases of this campus," said Loveman.

"The communities of Odessa and Midland have generously supported the development of the campus since its infancy, and I hope to bring some of the fruits of that investment back to this region in the form of well-trained physicians and faculty who practice quality state-of-the-art medicine," said Loveman.

Loveman attended the University of Michigan in Ann Arbor in 1969 and obtained his medical degree from Case Western Reserve University in Cleveland, Ohio in 1973. He did an internship at Martin Luther King Hospital in Los Angeles and completed his internal medicine residency at the University of British Columbia in 1977.

Before coming to TTUHSC in 1994, Loveman was in private practice and served as the medical director of the Coronary Care Unit and the medical director of the Cardiac Stress Testing Laboratory at Copley Hospital in Morrisville, Vt.

Loveman will continue to have an active rheumatology practice. His areas of research include adult consequences of childhood trauma and coccidiodomycosis in collagen vascular disease.


Texas Tech University Health Sciences Center announced the completion of Phase One in the expansion of the treatment capabilities at the Montford Regional Medical Facility (RMF). After two nurses were taken hostage by an inmate at University Medical Center on January 3, TTUHSC officials looked to expand the Montford Unit to serve as the primary medical treatment facility for more than 30,000 regional inmates.

James Laible, vice president of TTUHSC Health Care Systems and Hospital Relations, says Phase One was necessary to provide hospitalization and emergency care to the West Texas inmates in a facility where officers are trained to protect medical staff.

"We asked the Texas Department of Criminal Justice (TDCJ) to support the upgrade of the Montford RMF to a stand-alone, community type hospital," said Laible.

Laible says the Montford Unit had offered some inpatient medical treatment and outpatient surgical procedures, but was not equipped for intensive care services. Phase One construction converted the existing physical therapy department into an ICU, emergency and operating rooms.

"With these upgraded operating rooms, emergency room and ICU, we believe this hospital is now capable of providing 95 percent of the care that was being done at UMC," said Laible. "TDCJ has been supportive of this entire action, and we feel Texas Tech can continue its contractual operations and provide the inmate the health care as required, but in a more safe environment."

Laible credits the Lubbock legislative delegation for assisting in obtaining funding from TDCJ. "Senator Robert Duncan was most helpful with this arrangement and sponsored legislation to complete Phase Two," said Laible.

Laible added that the leadership of the Montford Unit, Warden William Stephens, and the staff were crucial in making these changes to the facility.

Phase One included adding 20 medical/surgical beds, developing an ICU, upgrading the Emergency Care Unit and the operating rooms, enhancing medical coverage, and upgrading hospital gasses. Total cost for Phase One of this project was $938,000.

Phase Two will include building an additional 44 bed nursing unit at the Montford campus as well as additional upgrading of the hospital support systems.


The Agency for Healthcare Research and Quality (AHRQ) has awarded Tyrone F. Borders, Ph.D., assistant professor of Health Services Research and Management at Texas Tech University Health Sciences Center, a grant to study Hispanic and rural elders satisfaction with health care.

David R. Smith, M.D., interim chancellor of the Texas Tech System, says this federal grant validates Tech's commitment to geriatric health care.

"The key here is that Texas Tech is taking a keen interest in what's happening in the communities of West Texas," said Smith. "As a result, it's really ventured into a non-traditional area, which is to look at population trends in these communities.

Texas Tech conducted the largest health poll to date of elderly West Texas residents. The Texas Tech 5000 Senior Poll assessed health status, access to health care, health concerns and health needs of a cross section of 5,000 West Texans who are 65 years of age or older.

James Rohrer, Ph.D., director of the Texas Tech 5000 Senior Poll, said the results of the poll will be used to help channel health programs and funding where they are needed most, and to assist in identifying and assessing the needs of elderly West Texans, particularly ethnic minorities and those who live in small towns and rural areas.

"The study's design was to lay a foundation for future research," says Rohrer. "What Borders has done is to apply for additional dollars to more deeply analyze the data, and this is potentially just the beginning."

Borders says this is an important area of funding because there is an increased concern about consumer perceptions. "Health care has traditionally focused on what providers think, not the consumer," says Borders. "This could theoretically affect how we organize health care in West Texas."

Joel Kupersmith, M.D., dean of the School of Medicine, says these grants are extremely competitive and difficult to obtain. "This grant puts us on the map with an important funding agency and will give us national recognition in the field of assessment of quality care. We will be at the forefront in this important area," said Kupersmith.


The School of Allied Health at the Texas Tech Health Sciences Center recently launched a Gait/Motion Analysis Laboratory within the Department of Rehabilitation Sciences, providing a platform for research and enhanced teaching, as well as offering an important clinical service for West Texas, said Paul P. Brooke Jr., Ph.D., dean of the School of Allied Health.

An open house marking the grand opening of the gait lab took place in May, along with the Balance Assessment and Energy Cost Assessment Laboratories. David R. Smith, M.D., president of the Texas Tech Health Sciences Center and interim chancellor of the Texas Tech University System, kicked off the events with a ribbon-cutting ceremony.

Students from all schools at the Health Sciences Center will gain valuable clinical experience from the three laboratories, said H.H. Merrifield, Ph.D., chairman of the department of rehabilitation sciences and associate dean of the School of Allied Health.

The Energy Cost Assessment Laboratory (ECAL) will feature state-of-the-art equipment for interdisciplinary research in cardiopulmonary, musculoskeletal and geriatric areas, said John Daniel, Ed.D., director of the lab and assistant professor in the department of rehabilitation sciences.

Equipment in the lab includes a Jaeger Oxycon Alpha, which measures physiological responses to increasing workloads. The unit analyzes, differentiates and quantifies exactly the functional cooperation of lungs, heart, circulation and cell metabolism. Improvements in physical performance can be measured objectively.

The ECAL also includes a Biodex underweighting support system, which allows patients with spinal cord injuries to work up to their normal walking speed gradually by supporting a percentage of their body weight. The patient wears a harness, which supports some of their weight while hey walk on a treadmill.

The Balance Assessment Laboratory features a Neurocom Smart Equitest, which assesses the ability of the body to maintain balance, said Steven Sawyer, Ph.D., director of the lab and assistant professor in the Texas Tech Health Sciences Center physical therapy program. The equipment can be used to analyze balance deficits in diabetics, those recovering from knee surgery, patients with inner ear problems and neurological conditions such as stroke and muscular dystrophy. The equipment also can serve as a tool for assessing falls among the elderly.

"We want to be a clinical resource for West Texans with balance disorders," Sawyer said.

The Gait/Motion Analysis Laboratory will allow researchers to evaluate movement patterns such as walking, reaching and standing. Gait analysis can be used to assist medical decisions involving treatment and interventions for various pathological conditions in children, adults and the aging population. Typical conditions evaluated by a gait lab include stroke, cerebral palsy, head injury, joint injuries or abnormalities, Parkinson's disease, multiple sports applications and falling among the aging population. Tasos Karakostas, Ph. D., and Merrifield serve as directors of the lab.


The convergence of information and technology has improved access to and the quality of education and health care. The Telecommunications Infrastructure Fund (TIF) Board has awarded the Texas Tech University Health Sciences Center a $1 million grant to enhance its information technology infrastructure and services.

David R. Smith, M.D., president of TTUHSC and interim chancellor of the Texas Tech University System, says this grant will make a difference in the way students learn about healthcare by incorporating information technology throughout their educational experience.

"This TIF grant is critical because of our commitment to link rural areas, and non-traditional partners such as nursing homes," said Smith. "The TTUHSC team in particular Dr. Patti Patterson and Mike Phillips and their staff has once more positioned Tech to maintain its national role in telemedicine and telecommunications."

In an area where a population of 2.6 million is scattered across more than 131,000 square miles, access to education and health care is out of the reach of many Texans. Mike Phillips, vice president for Information Technology at TTUHSC, says that TTUHSC utilizes information technology to overcome barriers of distance and geography to provide distance education, continuing education and health care services at the point of need.

"Through this TIF grant, we will enhance our network infrastructure to provide improved access to needed educational and clinical services, enhance our information systems for students and patients, enhance the security of our information technology environment, provide telemedicine access to burn clinic patients in the El Paso area, and upgrade our classrooms to enhance teaching and student education," said Phillips.

"We are pleased to have this strategic partnership with the TIF Board," added Phillips. "These TIF resources will be leveraged along with resources from the Sid Richardson Foundation and the United States Administration on Aging to enhance services for West Texans."


Within the first year of operation, the Clinical Trials Office markedly increased the number of contracts awarded to researchers on Texas Tech Health Sciences Center's four campuses.

Texas Tech executed 60 clinical trial contracts during fiscal year 2001, which have a potential of resulting in $3.6 million dollars for Texas Tech, said Barbara Pence, Ph.D., associate vice president for research and associate dean for research and the graduate school. In the previous year, there were 16 clinical trials executed between Texas Tech and 14 industry sponsors.

Texas Tech stands to benefit from the increase in contracts not only financially, but also in terms of reputation and recognition in the research arena, said Nancy Nisbett, M.S., director of research administration, who coordinates clinical trials at Lubbock.

"We definitely want to cover our costs, but more importantly these types of research initiatives provide opportunities for our faculty to join national studies, gaining them experience and expertise," she said. "That in turn could lead to opportunities for them to serve as primary investigators with these companies or acquire national grant funding for research of their own."

In addition, Nisbett said, patients gain access to cutting-edge medical care such as new technologies, therapies and medications, "that would not be available to them here otherwise."

Previously, clinical trials were one of several services conducted through the Office of Sponsored Programs. In September 2000, Pence and Joel Kupersmith, M.D., dean of the School of Medicine decided to create a new office to focus on Texas Tech's marketability in the clinical trials research arena.

"This model is one that has evolved in academic medical centers because in these particular studies, time is critical," Pence explained. "We felt that with the complexity of such contracts, and the pace at which they need attention, a separate office would benefit our investigators and the patients we serve."

Melissa Marsh, M.B.A., serves as director of the office and coordinates clinical trials among the regional campuses. She also performs extensive marketing of Texas Tech to pharmaceutical companies. Stacey Pugh, R.N., B.S.N., serves as clinical consultant.

Such dedicated resources provide an opportunity to inventory the expertise among Texas Tech's faculty and creates a base for increased networking among the campuses, Marsh said. "Being a multi-campus medical center with researchers on those campuses whose experience and expertise is congruent is particularly attractive to pharmaceutical companies because we can offer them four testing sites under one contract."

For example, pediatric asthma and infectious diseases are two areas of research that span the four campuses, she said. Texas Tech has clinical trials underway in those two areas as well as in obstetrics/gynecology, neuropsychiatry, internal medicine and diabetes.

"Our goal is to have anywhere from one to all four of the campuses involved in a given study," she added. "That strengthens our position in the research market as well as provides cohesion among our faculty."

Creating the office also enhanced curriculum in the School of Nursing to include clinical research, Pence said. "We need better trained staff to help in these studies; to offer that training elevates our status in the research community."

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By David R. Smith - President, TTUHSC

It all begins with a vision. It was as early as 1949 when Former Texas Governor Preston Smith envisioned a medical school for West Texas. It would take 20 years to make it a reality. The state legislature created the Texas Tech School of Medicine in 1969. Originally classes began in Drane Hall, and later the groundbreaking was held in 1973 for the Texas Tech University Health Sciences Center, which officially opened in 1976.

Preston Smith saw a need to provide more education for future medical professionals in the region. Who could have imagined that his vision would become the reality it is today.

Since 1972, the Health Sciences Center has cared for West Texans while graduating more than 2,000 physicians, more than 1,300 nurses, more than 1,500 allied health professionals, more than 50 pharmacists, 149 graduate students and completing the training of some 2,000 medical residents.

With a service area larger than all but four states, TTUHSC serves the health education needs of the more than 2.5 million residents of West Texas. More than 500,000 patient visits are made to Texas Tech campuses in Amarillo, El Paso, Lubbock and the Permian Basin.

As we discuss the master plan of this institution, we must look at our enrollment. While a number of health sciences centers across the country are closing down programs, the Texas Tech University Health Sciences Center is thriving.

Our health sciences center's largest enrollment increase is in the graduate school. We have gone from 48 students in 1998 to 90 this year. Dr. Barbara Pence should be commended on the way in which she has expanded our graduate program and the impact of research on this campus. She and her staff have made a decision to "think outside of the box." By more aggressively pursuing new programs and new students, the Graduate School of Biomedical Sciences have made this one of the most successful years with enrollment. A new look and a positive, imaginative and enthusiastic attitude have all contributed to a "student first" agenda.

Our School of Allied Health is the fastest growing school of allied health in the country with an unprecedented growth in new degree programs. In a country where there is a down market for traditional allied health programs, Dean Paul Brooke has the vision for implementing new academic programs. And the diversification of these academic programs is paying off. Enrollment is up from 452 last year to 499 this year, and every one of our programs is considered to be in the top tier by its accrediting agency.

Since 1998, the School of Nursing has seen an 8 percent increase in enrollment, and the School of Pharmacy, which graduated its first class in 2000, has some of the most outstanding graduates in the country. Their graduates received a 100 percent passage rate on the national board exam for the second time in a row. And the School of Medicine's enrollment is more diverse than ever this year; this year's class has the most Hispanics ever, and 52 percent of this year's entering class is female. We believe we have the diversity of programs such as aging, diabetes, border and rural healthcare, and a range of opportunities that is a rare commodity when compared to other educational institutions in the country.

All of these factors, combined with our research growth, assures us that our goal of reaching over 2,000 students by the end of the biennium is not only attainable, but within the realm of possibility. And we may even exceed it.

And this kind of growth levels the playing field. Our enrollment will rank us among the top institutions of this state and region. It is going to be a difficult legislative session, and the critical thing for us is going to be to continue to demonstrate to the legislature that we have a growing and vibrant university.

Since 1990, our enrollment has doubled. And while this master plan started with one man's vision, it has been the combined foresight of the planning and efforts of many who have helped us become an educational benchmark in Texas.

Texas Tech University Health Sciences Center continues to fulfill the health care needs of West Texas by anticipating the newest trends in healthcare, adapting to the changing needs of the patients we serve, and by setting the bar high in terms of the health care education and services it provides to the region.

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